﻿@*八字简批提交表单*@

<div class="aside-box">
    <div style="color:darkgray;" class="text-left aside-title">求测</div>

    <form id="bzjpForm" class="form-horizontal" role="form">
        <div class="form-group">
            <label class="col-xs-4 control-label" for="bzjp_name"> 姓名:</label>
            <div class="col-xs-8">
                <input class="form-control" type="text" id="bzjp_name" name="name" value="求测者" placeholder="姓名">
            </div>
        </div>
        <div class="form-group">
            <label class="col-xs-4 control-label" for="bzjp_place"> 出生地:</label>
            <div class="col-xs-8">
                <input class="form-control" type="text" id="bzjp_place" name="born_place" value="未知" placeholder="出生地">
            </div>
        </div>
        <div class="form-group">
            <label class="col-xs-4 control-label" for="bzjp_sex"> 性别:</label>
            <div class="col-xs-8">
                <div class="radio-inline">
                    <input type="radio" name="sex" id="bzjp_sex_male" value="true" checked="checked" /><label for="bzjp_sex_male">男</label>
                </div>
                <div class="radio-inline">
                    <input type="radio" name="sex" id="bzjp_sex_female" value="false" /><label for="bzjp_sex_female">女</label>
                </div>
            </div>
        </div>
        <div class="form-group">
            <label class="col-xs-4 control-label" for="bzjp_date">公历生日:</label>
            <div class="col-xs-8">
                <input class="form-control" style="width:160px;" onClick="WdatePicker({ dateFmt: 'yyyy-MM-dd HH:mm' })" type="text" id="bzjp_date" name="born_date" placeholder="生日">
            </div>
        </div>
        <div class="form-group">
            <label class="col-xs-4 control-label" for="bzjp_date">求测事项:</label>
            <div class="col-xs-8">
                <input class="form-control" type="text" id="bzjp_item" name="bzjp_item" list="bzjp_item_data">
                <datalist id="bzjp_item_data">
                    <option value="财运">财运</option>
                    <option value="事业">事业</option>
                    <option value="婚姻">婚姻</option>
                    <option value="健康">健康</option>
                </datalist>
            </div>
        </div>
        <div class="form-group">
            <label class="col-xs-4 control-label" for="bzjp_place"> 求测类型:</label>
            <div class="col-xs-8">
                <input class="form-control" type="text" id="bzjp_type" name="born_place" list="bzjp_type_data">
                <datalist id="bzjp_type_data">
                    <option value="八字">八字</option>
                    <option value="紫微斗数">紫微斗数</option>
                    <option value="六爻">六爻</option>
                </datalist>
            </div>
        </div>
        <div class="form-group">
            <div class="col-xs-4 col-sm-offset-4">
                <button type="button" class="btn btn-xs btn-info" onclick="bzjpSub()">申请八字简批</button>
                <div style="height:10px;"></div>
            </div>
        </div>
    </form>
</div>